According to the "Washington Manual of Surgery," carotid artery surgery is the most common type of vascular operation. The carotid arteries are large arteries located on either side of the neck that supply blood to the brain. A carotid endarterectomy, or carotid artery surgery, may be necessary if these arteries become blocked with atherosclerotic plaques. This surgery can have serious complications.
Stroke
According to VascularWeb, the risk of stroke due to a carotid endarterectomy is low, approximately 1 to 3 percent, but it is the most serious postoperative risk. If a stroke occurs within 12 to 24 hours postoperatively, it is typically caused by an embolism; either a blood clot or plaque that broke loose during the surgery and is now blocking an artery in the brain. This is a devastating complication that can cause many health complications and even death.
Wound Hematoma
After the operation, the neck is sutured and a tight dressing is placed at the site. The dressing acts as a compression device to help stop any bleeding, but because heparin, a blood-thinning medication, is used during the procedure, the blood is thin and bleeding can still occur, causing a hematoma, or blood collection, at the site. Small hematomas are usually not troublesome, but large hematomas that expand precipitously can cause airway compromise. When this occurs, the neck wound must be opened to alleviate the clot and restore the airway.
Nerve Injuries
According to VascularWeb, there is a rare but possible chance of injury to the nerves in the throat that can affect swallowing, lead to hoarseness, or numbness in the face or tongue. This is because the cranial nerves that make the tongue work and provide sensation to the face are located in the neck. The recurrent laryngeal nerve is very sensitive and lies within the same anatomical area as the carotid artery. Injury to this nerve, or even postoperative swelling of the neck, can create enough pressure on the nerve to cause the above-mentioned symptoms. These symptoms are not usually permanent and typically clear in less than a month.
References
- "Washington Manual of Surgery"; Gerald Doherty, et al.; 2002
- VascularWeb: Carotid Endarterectomy
- Encyclopedia of Surgery: Carotid Endarterectomy
- American Heart Association: Guidelines for Carotid Endarterectomy
